Our Lady of Grace Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OUR LADY OF GRACE MEDICAL CLINIC PC

Practice address

992 W 104TH Ave
Northglenn, CO 80234-3801

Phone

(303) 531-5181

Fax

(303) 531-5185

NPI assigned

Mar 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carlos F Vera, MDNPI 1023109188

Title

Ceo

Phone

(303) 531-5181

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos F Vera, M.D.

  • Family Medicine Physician
  • Westminster, CO
  • NPI 1023109188
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1356474647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350968",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800350968",
            "telephone_number": "303-531-5181",
            "fax_number": "303-531-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 W 104TH AVE",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802343801",
            "telephone_number": "303-531-5181",
            "fax_number": "303-531-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF GRACE MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-531-5181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92600786",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimal Eyecare, P.C.
• Optumcare Colorado Medical Group LLC
• Tara Orlandi
• Destinee Ornelas
• Kaylee Suzanne Oropallo, MS
• Chloe Pachovas
• Kenneth Padilla Jr., RBT
• Lorie Palmer
• Plamen Panayotov
• Gage Ethan Papierski, MSW

• Family Medicine Physician in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.